Effects of Mechanics for Uprighting Partially-Impacted Mandibular Second Molars using Miniscrew Anchorage: A Finite Element Analysis

Main Article Content

Puttnaree Kittichaithanakoon
Virush Patanaporn
Chaiy Rungsiyakull

Abstract

Objectives: The purposes of this study were: (1) to evaluate the optimal force magnitude that can be applied to the initial uprighting of partially-impacted mandibular second molar (tooth 37) without exceeding the hydrostatic pressure of the periodontal ligament (PDL) capillary vessels’ blood pressure, which is 0.0047 megapascal (MPa)
and distribution pattern of hydrostatic pressure on PDL 37; and (2) to describe initial tooth displacement of the impacted tooth 37, mandibular first molar (tooth 36) and mandibular second premolar (tooth 35) using the finite element method.
Materials and methods: A three-dimensional (3D) finite element model was developed from CBCT images. Various pushing forces, 35 to 150 g were applied to evaluate the optimal force magnitude. A force direction was laid from an interradicular miniscrew head, which was placed in the cortical bone between the root 35 and root 36, to a buccal minitube on the impacted tooth 37. The optimal force magnitude was used to simulate the initial tooth displacement of impacted tooth 37, tooth 36, and tooth 35.
Results: The optimal force magnitude, when a single-pushing-uprighting force applied, was 80 g. The compressive hydrostatic pressure on PDL 37 appeared on the disto-lingual region close to the cemento-enamel junction (CEJ); and the tension on PDL 37 appeared on the mesio-buccal side of the mesial root and on the mesio-buccal side of the distal root close to the furcation. The initial displacement pattern of the impacted tooth 37 was lingual crown tipping, distal crown tipping, distal root tipping, and disto-lingual rotation of the crown. It was found that the teeth 36 and 35 were also displaced, though force was not directly applied to them. Teeth 36 and 35 showed lingual crown tipping, extrusion, and distal crown tipping.
Conclusions: This finite element analysis was revealed that the force magnitude that can be applied to initial uprighting the mandibular second molar for this study was 80 g. The initial displacement pattern of the mandibular second molar, as descending order, was lingual crown tipping, distal crown tipping, distal root tipping and disto-lingual rotation of the crown. It was also revealed that the adjacent teeth were displaced, even though uprighting force was not directly applied to them.

Article Details

How to Cite
Kittichaithanakoon, P. ., Patanaporn, V. ., & Rungsiyakull, C. . (2021). Effects of Mechanics for Uprighting Partially-Impacted Mandibular Second Molars using Miniscrew Anchorage: A Finite Element Analysis. Chiang Mai Dental Journal, 42(3), 71–84. Retrieved from https://he01.tci-thaijo.org/index.php/cmdj/article/view/252424
Section
Original article

References

1. Cassetta M, Altieri F, Di Mambro A, Galluccio G, Barbato E. Impaction of permanent mandibular second molar: A retrospective study. Med Oral Patol Oral Cir Bucal. 2013; 18(4):564.
2. Lau CK, Whang CZ, Bister D. Orthodontic uprighting of severely impacted mandibular second molars. Am J Orthod Dentofacial Orthop. 2013; 143(1):116-24.
3. Fu PS, Wang JC, Wu YM, Huang TK, Chen WC, Tseng YC, et al.Impacted mandibular second molars: A retrospective study of prevalence and treatment outcome. Angle Orthod. 2012;82(4):670-5.
4. Chintakanon K, Boonpinon P. Ectopic eruption of the first permanent molars: prevalence and etiologic factors. Angle Orthod. 1998;68(2):153-60.
5. Mah SJ, Won PJ, Nam JH, Kim EC, Kang YG. Uprighting mesially impacted mandibular molars with 2 miniscrews. Am J Orthod Dentofacial Orthop. 2015;148(5):849-61.
6. Sivolella S, Roberto M, Bressan P, Bressan E, Cernuschi S, Miotti F, et al. Uprighting of the impacted second mandibular molar with skeletal anchorage. In: Bourzgui F, ed: Orthodontics-Basic Aspects and Clinical Considerations. 1st ed. Rijeka: InTech; 2012: 247-64.
7. Lee KJ, Park YC, Hwang WS, Seong EH. Uprighting mandibular second molars with direct miniscrew anchorage. J Clin Orthod. 2007;41(10):627-35.
8. Musilli M, Marsico M, Romanucci A, Grampone F. Molar uprighting with mini screws: comparison among different systems and relative biomechanical analysis. Prog Orthod. 2010;2(11):166-73.
9. Magkavali-Trikka P, Emmanouilidis G, Papadopoulos MA. Mandibular molar uprighting using orthodontic miniscrew implants: a systematic review. Prog Orthod. 2018; 19(1):1-12.
10. Raghoebar G, Boering G, Vissink A, Stegenga B. Eruption disturbances of permanent molars: a review. J Oral Pathol Med. 1991;20(4):159-66.
11. Proffit WR, Sarver DM. Contemporary orthodontics appliances. In: Duncan L, ed: Contemporary orthodontics. 5th ed. Missouri: Elsevier Health Sciences; 2013:347-94.
12. Shellhart WC, Oesterle LJ. Uprighting molars without extrusion. J Am Dent Assoc. 1999; 130(3):381-85.
13. Roberts III WW, Chacker FM, Burstone CJ. A segmental approach to mandibular molar uprighting. Am J Orthod. 1982;81(3):177-84.
14. Sawicka M, Racka Pilszak B, Rosnowska Mazurkiewicz A. Uprighting partially impacted permanent second molars. Angle Orthod. 2007; 77(1):148-54.
15. Majourau A, Norton LA. Uprighting impacted second molars with segmented springs. Am J Orthod Dentofacial Orthop. 1995;107(3):235-38.
16. Tuncay OC, Biggerstaff RH, Cutcliffe JC, Berkowitz J. Molar uprighting with T-loop springs. J Am Dent Assoc. 1980; 100(6):863-66.
17. Kim MH, Kim M, Chun YS. Molar uprighting by a nickel-titanium spring based on a setup model. Am J Orthod Dentofacial Orthop. 2014;146(1): 119-23.
18. Lee KJ, Park YC. The biomechanics of miniscrews. In: Leah H, ed: The biomechanical foundation of clinical orthodontics. 1st ed. Hanover park: Quintessence Publishing; 2015: 433-50.
19. Giancotti A, Arcuri C, Barlattani A. Treatment of ectopic mandibular second molar with titanium miniscrews. Am J Orthod Dentofacial Orthop. 2004; 126(1):113-17.
20. Rubin C, Krishnamurthy N, Capilouto E, Yi H. Stress analysis of the human tooth using a three-dimensional finite element model. J Dent Res. 1983;62(2): 82-6.
21. Schwarz AM. Tissue changes incidental to orthodontic tooth movement. Int J Dent. 1932;18(4):331-52.
22. Kojima Y, Fukui H. Numeric simulations of en-masse space closure with sliding mechanics. Am J Orthod Dentofacial Orthop. 2010;138(6):702.e1- .e6.
23. Kojima Y, Fukui H. Numerical simulation of canine retraction by sliding mechanics. Am J Orthod Dentofacial Orthop. 2005;127(5):542-51.
24. Kojima Y, Mizuno T, Fukui H. A numerical simulation of tooth movement produced by molar uprighting spring. Am J Orthod Dentofacial Orthop. 2007;132(5):630-38.
25. Kojima Y, Takano M, Fukui H, Mizutani N, Hasegawa J. A simple method for calculating the initial tooth mobility and stress distribution in the periodontal ligament. Dent Mater J. 1999;18:210-16.
26. Bittencourt LP, Raymundo MV, Mucha JN. The optimal position for insertion of orthodontic miniscrews. Revista Odonto Ciência. 2011;26(2):133-38.
27. Borchers L, Reichart P. Three-dimensional stress distribution around a dental implant at different stages of interface development. J Dent Res. 1983;62(2):155-59.
28. Tanne K, Sakuda M, Burstone CJ. Three dimensional finite analyses for strss distribution in the periodontal tissue by orthodontic forces. Am J Dentofacial Orthop. 1987;92(6):499-505.
29. Cifter M, Sarac M. Maxillary posterior intrusion mechanics with mini-implant anchorage evaluated with the finite element method. Am J Orthod Dentofacial Orthop. 2011; 140(5):e233-41.
30. Toms SR, Eberhardt AW. A nonlinear finite element analysis of the periodontal ligament under orthodontic tooth loading. Am J Orthod Dentofacial Orthop. 2003; 123(6):657-65.
31. Tanne K, Yoshida S, Kawata T, Sasaki A, Knox J, Jones ML. An evaluation of the biomechanical response of the tooth and periodontium to orthodontic forces in adolescent and adult subjects. Br J Orthod. 1998;25(2):109-15.
32. Williams K, Edmundson J. Orthodontic tooth movement analysed by the finite element method. Biomaterials. 1984;5(6):347-51.
33. Huang H, Tang W, Yan B, Wu B. Mechanical responses of Periodontal Ligament under a realistic orthodontic loading. Procedia Eng. 2012;31:828-33.
34. Murakami N, Wakabayashi N. Finite element contact analysis as a critical technique in dental biomechanics: a review. J Prosthodont Res. 2014;58(2):92-101.
35. Davidovitch Z. Tooth movement. Crit Rev Oral Biol Med. 1991; 2(4):411-50.
36. Ren Y, Maltha JC, Kuijpers-Jagtman AM. Optimum force magnitude for orthodontic tooth movement: a systematic literature review. Angle Orthod. 2003;73(1):86-92.
37. Melsen B. Tissue reaction to orthodontic tooth movement—a new paradigm. Eur J Orthod. 2001;23(6):671-81.
38. Viecilli RF. Stress, Strain, and the biological response. In: Leah H, ed: The Biomechanical Foundation of clinical orthodontics. 1st ed. Hanover park: Quintessence Publishing; 2015: 209-226.
39. Yousefian J, Firouzian F, Shanfeld J, Ngan P, Lanese R, Davidovitch Z. A new experimental model for studying the response of periodontal ligament cells to hydrostatic pressure. Am J Orthod Dentofacial Orthop. 1995; 108(4):402-09.
40. Gracco A, Lombardo L, Cozzani M, Siciliani G. Uprighting mesially inclined mandibular second molars with a modified Uprighter Jet. J Clin Orthod. 2007;41:281-84.
41. Gu G, Lemery SA, King GJ. Effect of appliance reactivation after decay of initial activation on osteoclasts, tooth movement, and root resorption. Angle Orthod. 1999;69(6):515-22.
42. Andreasen GF, Zwanziger D. A clinical evaluation of the differential force concept as applied to the edgewise bracket. Am J Orthod Dentofac Orthop. 1980;78(1):25-40.
43. Romeo DA, Burstone CJ. Tip-back mechanics. Am J Orthod. 1977;72(4):414-21.
44. Smith RJ, Burstone CJ. Mechanics of tooth movement. Am J Orthod. 1984;85(4):294-307.
45. Nabbout F, Baron P. Anchorage in orthodontics: Three-dimensional scanner input. J Int Soc Prev Community Dent. 2018;8(1):6.
46. Proffit WR. The biologic basic of orthodontic therapy. In: Duncan L, ed: Contemporary orthodontics. 5th ed. Missouri: Elsevier/Mosby;2013:278-311.
47. Bondemark L, Tsiopa J. Prevalence of ectopic eruption, impaction, retention and agenesis of the permanent second molar. Angle Orthod. 2007;77(5):773-8.
48. Geng J-P, Tan KB, Liu G-R. Application of finite element analysis in implant dentistry: a review of the literature. J Prosthet Dent. 2001;85(6):585-98.
49. Piccioni MAR, Campos EA, Saad JRC, de Andrade MF, Galvão MR, Rached AA. Application of the finite element method in Dentistry. Rev Bras Odontol. 2013;10(4):369-77.
50. Mohammed S, Desai H. Basic concepts of finite element analysis and its applications in dentistry: An overview. Int J Dent Hyg. 2014:1-5.
51. Cattaneo P, Dalstra M, Melsen B. The finite element method: a tool to study orthodontic tooth movement. J Dent Res. 2005; 84(5):428-33.